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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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ST Segment Elevation Myocardial Infarction Due to Severe Ostial Left Main Stem Stenosis in a Patient with Syphilitic

L M Predescu, L Zarma, P Platon

    Romanian Journal of Internal Medicine = Revue Roumaine De Medecine Interne
    |May 5, 2016
    PubMed

    Insights

    Tertiary syphilis can cause rare but serious heart conditions like syphilitic aortitis, leading to myocardial infarction. Early diagnosis and treatment are crucial for managing this cardiovascular syphilis manifestation.

    Area of Science:

    • Cardiology
    • Infectious Diseases
    • Vascular Medicine

    Background:

    • Tertiary syphilis, though uncommon, is a significant cause of cardiovascular morbidity and mortality.
    • Syphilitic aortitis classically presents with aortic regurgitation, ascending aorta dilation, and ostial coronary artery lesions.

    Observation:

    • A 36-year-old male presented with acute anterior ST-segment elevation myocardial infarction and cardiogenic shock.
    • Echocardiography revealed severe left ventricular systolic dysfunction, mitral regurgitation, moderate aortic regurgitation, and ascending aorta dilation.
    • Coronary angiography identified a critical ostial left main coronary artery stenosis.

    Findings:

    • The patient underwent urgent stent implantation for the left main stenosis and received an intra-aortic balloon pump.
    • Positive syphilitic infection tests confirmed the diagnosis.
    • This case highlights syphilitic aortitis presenting acutely as ST-segment elevation myocardial infarction.

    Implications:

    • Syphilitic aortitis can manifest acutely, mimicking other causes of myocardial infarction, necessitating broad diagnostic considerations.
    • Percutaneous coronary intervention is a viable treatment for acute syphilitic left main stenosis.
    • Long-term follow-up is essential due to the risk of in-stent restenosis from ongoing aortitis.

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